Job Snapshot

Job Description

ABOUT THE POSITION

The Manager of Network Development & Contracting in Woburn, MA leads all territory network development and contract management activities for a growing and complex managed behavioral health care organization.The position is responsible for network development, contracting, and rate negotiations for their assigned territory.Duties include identifying and contracting new/ re-contracting existing providers around Beacon’s need for services, negotiating rates, drafting provider services agreements, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and ensuring rates negotiated are within established guidelines.

Position Responsibilities:

Negotiate rates and contract terms with currently contracted providers.

In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network.

Perform reimbursement analysis on providers that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.

Identify opportunities for cost savings and process improvements related to the contracting process.

Review and draft suggested language changes, and oversee resolution of all proposed changes to the provider services agreement.

Participate in provider meetings, trainings.

Ensure that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.